Controlling Specialty Costs
We have identified an opportunity to save members millions of dollars in specialty medication costs – by managing specialty medication prior authorization functions within our Cooperative.
We conservatively estimate $3.5 to $5 million in savings across our Cooperative in specialty medication prior authorization functions alone. In addition to saving our members money, improving the participant experience is another major goal of our in-house Specialty Medication Prior Authorization program. This shift in responsibility leads to a more high-touch clinical review of our participants’ specialty medications.